TITLE:
Obstetric Hemorrhage during the Third Trimester of Pregnancy: Experience in a University Hospital in Guinea
AUTHORS:
Fatoumata Bamba Diallo, Elhadj Mamoudou Bah, Massa Keita, Abdoul Aziz Baldé, Ibrahima Sory Baldé, Telly Sy, Namory Keita
KEYWORDS:
Obstetric Hemorrhage in the Third Trimester, Etiologies, Management and Prognosis, Ignace Deen, Guinea
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.4,
April
29,
2022
ABSTRACT: Aims: Obstetric hemorrhage,
especially during the 3rd trimester of pregnancy,
causes maternal, fetal and neonatal mortality and morbidity. We attempted
to characterize its clinical features in Guinea. The objectives of this study
were to describe the socio-demographic characteristics of the patients,
identify the causes and contributing factors, describe the management and
evaluate the maternal-fetal prognosis in such patients. Methods: We
retrieved and analyzed patients with 3rd trimester hemorrhage whom we managed
at Ignace Deen National Hospital, Guinea during 1-year period (1st of December 2019-30th of November 2020). Results: We
experienced recorded 401 patients with 3rd trimester obstetric hemorrhage out
of 5468 deliveries during the corresponding period; the rate being 7.33%. The
main causes were as follows: placental hematoma (65.33%), placenta previa
(27.68%) and uterine rupture (6.99%). The socio-demographic profiles were as
follows: the age group of 25 - 29 years (28.42%), married (94.51%), uneducated
(50.12%), and with a liberal profession. (43.64%) and pauciparous (30.42%). The
conditions were considered to be preventable by managing risk factors during
the prenatal consultation (PNC): 7.73%
underwent no PNC. Cesarean accounted for 84.78% of patients. Prognosis
was as follows: 14 maternal deaths (3.45% of a fatality), 34.66% of anemia, and
16.95% of hemorrhagic shock. Fetal/neonatal prognoses were poor. Conclusion: Obstetric hemorrhage during 3rd trimester remains the main cause of poor
outcomes in Guinea. This study identified that this type of hemorrhage still
represents an important cause of maternal and fetal morbidity and mortality in
developing countries.